Otorhinolaryngology and Skull Base Center, Assistance Publique - Hôpitaux de Paris, Hôpital Lariboisière, Université Paris Cité, Paris, France.
Otolaryngology - Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Canada.
Sci Prog. 2024 Jul-Sep;107(3):368504241274583. doi: 10.1177/00368504241274583.
Epistaxis is a recurring cause for referral to emergency departments. Its management can be complex; hence, it is critical to provide appropriate support to Otolaryngology-Head and Neck Surgery (OHNS) residents to develop clinical reasoning skills to manage such cases. Learning-by-Concordance (LbC) is a recently developed educational tool that encourages learners to think through simulated clinical scenarios. A panel of ENTs provides insightful feedback to residents, reflecting a diversity of opinions about practice. Our study aimed to assess LbC's feasibility and perceived value for training OHNS residents in epistaxis management.
In this qualitative study, three OHNS surgeons, including two faculty members and one resident, wrote the LbC scenarios. The LbC tool was made available to participants through an online platform. A panel of four OHNS faculty provided feedback on answers to LbC questions. Otolaryngology-Head and Neck Surgery residents participated and provided their opinion on the value of this educational tool through an online questionnaire.
A total of 10 one-hour sessions were required to create and upload the training tool. To provide insightful feedback embedded in the learning tool, the four panelists needed 60 min each. Of the 37 participating residents, 25 (68%) completed the training. Overall satisfaction was high: 88% appreciated the training method, and 92% wanted to use this type of training again. Most residents felt the training enabled them to improve their clinical reasoning when encountering a patient with epistaxis (92%) and their knowledge about epistaxis (96%).
Findings suggest that OHNS residents could benefit from clinical reasoning exercises with panelist feedback using the LbC approach for clinical presentations that require complex approaches to manage conditions such as epistaxis.
鼻出血是急诊转诊的常见原因。其治疗可能较为复杂；因此，为耳鼻喉头颈外科（ENT）住院医师提供适当的支持以培养其临床推理能力来处理此类病例至关重要。学习一致性（LbC）是一种新开发的教育工具，鼓励学习者通过模拟临床情况进行思考。一组 ENT 专家为住院医师提供深入的反馈，反映了对实践的不同看法。我们的研究旨在评估 LbC 在培训 ENT 住院医师处理鼻出血方面的可行性和感知价值。
在这项定性研究中，三位耳鼻喉科外科医生（包括两位教员和一位住院医师）编写了 LbC 情景。通过在线平台向参与者提供 LbC 工具。一个由四位 ENT 教员组成的小组对 LbC 问题的答案提供反馈。耳鼻喉头颈外科住院医师参与并通过在线问卷对该教育工具的价值发表意见。
共需 10 个小时来创建和上传培训工具。为了在学习工具中提供嵌入的深入反馈，四位小组成员每人需要 60 分钟。在 37 名参与的住院医师中，有 25 名（68%）完成了培训。总体满意度很高：88%的人赞赏培训方法，92%的人希望再次使用这种类型的培训。大多数住院医师认为这种培训使他们在遇到鼻出血患者时能够提高临床推理能力（92%）和对鼻出血的了解（96%）。
研究结果表明，OHNS 住院医师可以从使用 LbC 方法进行具有小组成员反馈的临床推理练习中受益，这种方法适用于需要复杂方法来治疗鼻出血等疾病的临床表现。
